The value of multiparametric contrast-enhanced ultrasound-guided targeted biopsy in the early diagnosis of prostate cancer

The application efficacy of multiparametric contrast-enhanced ultrasound-guided targeted prostate biopsy in early diagnostic assessments for patients with suspected prostate cancer (PCa) was evaluated in this study. A single-center prospective diagnostic investigation was carried out, and a sequential cohort of 112 patients with clinically suspected PCa was recruited for the research. Every enrolled patient underwent transrectal multiparametric ultrasonic scanning, which encompassed Brightness mode (B-mode), Color Doppler Flow Imaging (CDFI), Strain Elastography (SE), and Dynamic Contrast-Enhanced Ultrasound (DCE-US). Systematic 12-core biopsy and targeted biopsy targeting suspicious lesions identified via multiparametric imaging were implemented on each patient in a sequential manner. Taking postoperative pathological findings as the gold standard, comparisons were made regarding the lesion detection efficiency, single-core positive rate of targeted biopsy, as well as diagnostic performance (sensitivity, specificity, Area Under the Receiver Operating Characteristic Curve [AUC]) across diverse ultrasound modalities and their various combined applications. Incremental analysis was used to quantify the diagnostic gain of the multimodal combination compared with the best single modality. The combined full-mode ultrasound (B + CDFI + SE + DCE-US) achieved the highest detection rate of malignant lesions (79.9%), and the single-core positive detection rate of targeted biopsy guided by it reached 79.9%, which was markedly superior to the corresponding 21.3% recorded for systematic biopsy ( P < 0.05). Incremental analysis showed that the number of positive lesions detected by the full multimodal combination was approximately twice that of the best single modality (DCE-US), with an incremental ratio of 1.99 (95% CI: 1.88–2.12). In terms of diagnostic performance, the combined full-mode ultrasound obtained an AUC of 0.952 and a sensitivity of 97.1%, which were significantly superior to any single ultrasound mode or partial combination ( P < 0.05). The CDFI Adler grade, SE score, Dynamic Contrast-Enhanced Ultrasound Peak Enhancement (PE), and Wash-out Rate (WR) exhibited markedly elevated levels in the malignant group in contrast to the corresponding metrics measured in the benign group, with the intergroup differences reaching extremely statistically significant ( P < 0.001). Multiparametric contrast-enhanced ultrasound, by integrating the complementary information from B-mode ultrasound, CDFI, SE, and DCE-US, can significantly improve the detection efficiency and diagnostic accuracy of targeted biopsy for PCa, providing an economical and accessible precision imaging alternative in clinical scenarios where multiparametric magnetic resonance imaging is unavailable or limited.